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Adam G. > Assessment: Skin, Hair, Nails > Flashcards

Assessment: Skin, Hair, Nails Flashcards

1
Q

What is the name of a lesion that is circular, begins int he center and spreads to the periphery
(e.g. tinea corporis or ringworm, tinea versicolor, pityriasis rosea)

A

Annular

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2
Q

What is the name of a lesion where the lesions run together (e.g. urticaria [hives])

A

Confluent

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3
Q

What is the name of a lesion that is distinct and individual, remains separate (e.g. acrochordon or skin tags, acne)

A

Discrete

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4
Q

What is the name of a lesion that is twisted, coiled spiral, snakelike?

A

Gyrate

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5
Q

What is the configuration of a lesion that is clustered (e.g. vesicles of contact dermatitis)?

A

Grouped

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6
Q

What is the shape of a lesion that is a streak, line, stripe, or scratch?

A

Linear

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7
Q

What is the configuration of a lesion that is made of concentric rings of color (e.g. as we would see with Lyme’s disease, erythema multiforme)

A

Target

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8
Q

What is the configuration of a lesion that is linear in arrangement along a unilateral nerve route (e.g. herpes zoster).

A

Zosteriform

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9
Q

What is the configuration of a lesion that is made up of annular (circular) lesions that grow together (e.g. lichen planus, psoriasis).

A

Polycyclic

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10
Q

Describe a “macule” lesion

A

Soley a color change, flat and circumscribed,

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11
Q

Describe a “patch” lesion

A

Macules that are > 1 cm. Examples: Mongolian spot, vitiligo, cafe au lait spot, chloasma, measles rash.

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12
Q

Describe a “nodule” lesion

A

Solid, elevated, hard or soft, larger than 1 cm. May extend deeper into dermis than papule. Examples: Xanthoma, fibroma, intradermal nevi

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13
Q

Describe a “tumor” lesion

A

Larger than a few centimeters in diameter, firm or soft, deeper into dermis; may be benign or malignant, although “tumor” implies “cancer” to most people. Examples: lipoma, hemangioma

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14
Q

Describe a “papule” lesion

A

Something you can “feel” (i.e. solid, elevated, circumscribed,

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15
Q

Describe a “plaque” lesion

A

Papules coalesce to form surface elevation wider than 1 cm. A plateau-like, disk-shaped lesion. Examples: psoriasis, lichen planus.

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16
Q

Describe a “wheal” lesion

A

Superficial, raised, transient, and erythematous; slightly irregular shape due to edema. Examples: Mosquito bite, allergic reaction, dermographism

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17
Q

Describe an “urticaria” (hives) lesion

A

Wheals coalesce to form extensive reaction, intensely pruritic

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18
Q

Describe a “vesicle” lesion

A

Elevated cavity containing free fluid, up to 1 cm; a “blister”. Clear serum flows if wall is ruptured. Examples: herpes simplex, early varicella (chickenpox), herpes zoster (shingles), contact dermatitis.

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19
Q

Describe a “bulla” lesion

A

Larger than 1 cm diameter; usually single chambered (unilocular); superficial in epidermis; it is thin walled, so it ruptures easily. Examples: friction blister, pemphigus, burns, contact dermatis

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20
Q

Describe a “cyst” lesion

A

An encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevating skin. Examples: sebaceous cyst, wen.

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21
Q

Describe a “pustule” lesion

A

Turbid fluid (pus) in the cavity. Circumscribed and elevated. Examples: impetigo, acne

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22
Q

Describe a “crust” lesion

A

The thickened, dried-out exudate left when vesicles/pustules burst or dry up. Color can be red-brown, honey, or yellow, depending on the fluid’s ingredients (blood, serum, pus). Examples: Impetigo (dry, honey-colored), weeping eczematous dermatitis, scab after abrasion

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23
Q

Describe a “scale” lesion

A

Compact, desiccated flakes of skin, dry or greasy, silvery or white, from shedding of dead excess keratin cells. Examples: after scarlet fever or drug reaction (laminated sheets), psoriasis (silver, mica-like), seborrheic dermatitis (yellow, greasy), eczema, ichthyosis (large, adherent, laminated), dry skin.

24
Q

Describe a “fissure” break in the skin

A

Linear crack with abrupt edges, extends into dermis, dry or moist. Examples: cheilosis - at corners of mouth due to excess moisture; athlete’s foot.

25
Q

Describe an “erosion” break in the skin

A

Scooped out but shallow depression. Superficial; epidermis lost; moist but no bleeding; heals without scar because erosion does not extend into dermis.

26
Q

Describe an “ulcer” break in the skin

A

Deeper depression extending into dermis, irregular shape; may bleed; leaves scar when heals. Examples: Stasis ulcer, pressure sore, chancre

27
Q

Describe an “excoriation” break in the skin

A

Self-inflicted; Superficial; sometimes crusted; scratches from intense itching. Examples: insect bites, scabies, dermatitis, varicella

28
Q

Describe a “scar”

A

After a skin lesion is repaired, normal tissue is lost and replaced with connective tissue (collagen). This is a permanent fibrotic change. Examples: healed area of surgery or injury, acne

29
Q

Describe an “atrophic scar”

A

The resulting skin level is depressed with loss of tissue; a thinning of the epidermis. Example: striae

30
Q

Describe a “lichenfication” lesion

A

Prolonged, intense scratching eventually thickens the skin and produces tightly packed sets of papules; looks like surface of moss (or lichen)

31
Q

Describe a “keloid” lesion

A

A hypertrophic scar. The resulting skin level is elevated by excess scar tissue, which is invasive beyond the site of original injury. May increase long after healing occurs. Looks smooth, rubbery, and has a higher incidence among Blacks.

32
Q

What are risk factors for pressure ulcers?

A

Impaired mobility; thin fragile skin from aging; decreased sensory perception (unable to respond to pain); impaired level of consciousness; moisture; incontinence; shearing (being pulled down or across the bed); poor nutrition; infection

33
Q

What does a “stage I pressure ulcer” look like?

A

Intact skin appear red but unbroken. Localized redness in lightly pigmented skin will blanch (turns light with fingertip pressure). Dark skin appears darker but does not blanch.

34
Q

What does a “stage II pressure ulcer” look like?

A

Partial-thickness skin erosion with loss of epidermis or also the dermis. Superficial ulcer looks shallow like an abrasion or open blister with a red-pink wound bed.

35
Q

What does a “stage III pressure ulcer” look like?

A

Full-thickness pressure ulcer extending into the subcutaneous tissue and resembling a crater. May see subcutaneous fat but not muscle, bone, or tendon.

36
Q

What does a “stage IV pressure ulcer” look like?

A

Full-thickness pressure ulcer involves all skin layers and extends into supporting tissue. Exposes muscle, tendon, or bone, and may show slough (stringy matter attached to wound bed) or eschar (black or brown necrotic tissue).

37
Q

What is a lack of color in an area of skin called?

A

Hypopigmentation

38
Q

What is an increase in color in an area of skin called?

A

Hyperpigmentation

39
Q

What changes in moles should we question?

A

Changes in color, size, shape, sudden tenderness, bleeding, itching.

40
Q

What does “seborrhea” mean?

A

oily

41
Q

What are some observations we can make when assessing a rash or lesion?

A

When did you first notice it?
Where did it start?
Where did it spread?
Color?
Raised or flat? Any crust, odor? Does it feel tender, warm?
How long have you had it?
Anyone at home/work with similar rash? Have you been camping, acquired a new pet, tried a new food/drug? Does the rash come with stress?
What home care have you tried for it? Do any make it better/worse?
Any itching, fever?
Has the lesion affected your ability to function?

42
Q

What is “alopecia”?

A

A significant loss of hair

43
Q

What is “hirsutism”?

A

Shaggy or excessive hair

44
Q

True or False: Acne is caused by factors such as poor diet, oily complexion, or contagion?

A

False. The cause is still unknown.

45
Q

What is “vitiligo”?

A

The complete absence of melanin pigment in patchy areas of white or light skin. Can occur in all races.

46
Q

What are “danger signs”, or abnormal characteristics of lesions (think ABCDE)?

A 
A = Asymmetry
B = Border irregularity
C = Color variation (areas of brown, tan, black, blue, red, white, or combination
D = Diameter (>6 mm)
E = Elevation or Enlargement
47
Q

What areas of skin may be best to assess on dark skinned individuals?

A

Under the tongue, buccal mucosa, palpebral conjunctiva, nail beds, and sclera

48
Q

How can we assess for dehydration?

A

Inspect mucous membranes; Test skin fold for turgor

49
Q

What are the grades of edema?

A

1+ Mild pitting, slight indentation, no perceptible swelling of the leg
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains for a short time, leg looks swollen
4+ Very deep pitting, indentation lasts a long time, leg is very swollen

50
Q

What is generalized edema of the whole body?

A

Anasarca

51
Q

What is a normal angle of the nail bed?

A

160 degrees

52
Q

What does early clubbing of a nail look like?

A

Nail straightens to 180 degrees

53
Q

In a newborn, what is “erythema toxicum”?

A

A common rash that appears in the first 3-4 days of life. Consists of tiny red macules and papules on the cheeks, trunk, chest, back, and buttocks. No treatment needed.

54
Q

How would anemia look in Light vs. Dark skin

A

Light: Generalized pallor
Dark: Brown skin is yellow-brown, dull; Black skin appears ashen gray, dull (check conjunctivae, mucous membranes

55
Q

How would local arterial insufficiency look in Light vs. Dark skin

A

Light: Marked localized pallor (e.g. lower extremities, especially when elevated)
Dark: Ashen gray, dull; cool to palpatation

Adam G. (12 decks)

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